Multi-specialty integrated care scheduling system

ABSTRACT

A method of automated medical scheduling of an autonomous vehicle to pick up a patient including the steps of receiving data on a processor via a checklist, said data being a plurality of predetermined physical conditions of a patient, each of the plurality of predetermined physical conditions having a predetermined assigned weight based on level of severity, generating a summation of the total weight for each predetermined physical condition, generating a predetermined specialty acuity score by comparing the corresponding range of the total weight and generating a report to output of the specialty acuity score, the specialty acuity score used to determine priority of scheduling patients in a system. A specialty acuity score may be generated for each system affected, the systems each assigned a value of 1. A comorbidity score may be generated by the summation of each system.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part application of U.S.application Ser. No. 16/112,835 filed on Aug. 27, 2018, acontinuation-in-part application of U.S. application Ser. No. 16/751,832filed on Jan. 24, 2020, a continuation-in-part application of U.S.application Ser. No. 16/939,203, a continuation-in-part application ofU.S. application Ser. No. 16/939,216, claims priority and benefit toProvisional Patent Application Ser. No. 62/878,788 filed on Jul. 26,2019, claims priority and benefit to Provisional Patent Application Ser.No. 62/878,793 filed Jul. 26, 2019, claims priority and benefit toProvisional Patent Application Ser. No. 63/018,830 filed May 1, 2020.and claims priority and benefit to Provisional Patent Application Ser.No. 63/120,369 filed Dec. 2, 2020.

TECHNICAL FIELD

The present specification generally relates to a schedule and recordkeeping system and, more specifically, a multi-specialty integrated careclinic and laboratory scheduling system.

BACKGROUND

Scheduling patients for follow up visits at their primary care physicianor specialist office is traditionally random and done in anon-standardized and oftentimes isolated manner. This leads to multipleuncoordinated, with multiple different sets of lab work andinvestigations at different times and segregated that can be veryduplicative. With an aging population, with multiple medical problemspresent in each patient, there is an increasing desire from clinicians,funding agencies, etc., to coordinate care health care in acost-effective manner, for a more holistic and effective approach topatient centered care. However, a solution has not yet been effectivelyimplemented.

There are numerous factors to be considered when scheduling a patient'sfollow up visit such as patient load in a physician's practice, theirwaiting list, as well as individual physician and patient availabilitybased on other commitments. The patient's clinical status certainlyfactors in, but not in a standardized fashion. This can lead to a lackof timely follow up for patients and has the potential to the increaseutilization of emergency rooms and a higher need for hospitalization.

In addition, individual physicians (involved in any given patient'scare) office scheduling systems, assessments, and laboratory andinvestigation requisitions are not coordinated and care is notintegrated optimally as a result. Alert notification systems for reviewof pertinent lab work is isolated and not coordinated among careproviders.

Accordingly, there exists a need in the art to provide a system andmethod to overcome the aforementioned disadvantages.

The frequency and priority of scheduling of visits andlab/investigations across multiple specialties needs to mirror theclinical needs of the patient. Due to the traditional physician clinicsetup being individualized and not integrated across differentspecialists' and primary care offices, each most often having differentphysical locations, electronic medical record (EMR) systems, andscheduling systems that are individual provider based, the coordinationof visits of more than one specialist is nearly impossible for same dayor even the same physical building. This leads to many patient's onlyinteracting with their primary care physician or specialist on as neededbasis, rather than in accordance with their medical needs. In addition,prior to each individual appointment with primary care physicians andspecialists, laboratory and other investigations are often necessary anddone in significant duplication prior to each individual clinic visitwith different physicians.

Duplication of lab investigations comes at great cost, inconvenience, aswell as time away from productive activity for patients. Often theresults of these investigations are not specifically copied to allphysicians in the circle of care, and very specific tests needed by anyindividual physician are often repeated even if results from anotherphysician are available. There is currently no system to coordinateefficient same day and/or same site follow up visits between differentspecialties to allow multi-specialty intervention that meets thepriority needs of any individual patient, while making sure the careremains comprehensive as well. This is a significant problem within thehealthcare system and contributes to a lack of access to timelyintervention. The lack of timely access is known to influence outcomesfor patients. It also leads to inefficient duplication of services andlaboratory/investigations and increased health care costs as well as aloss of time and inconvenience to patients within the system due tomultiple visits to the laboratory as well as to different specialty andprimary care clinics.

Accordingly, there exists a need in the art to provide a system andmethod to overcome the aforementioned disadvantages. The system providedherein provides for multi-specialty scheduling andlaboratory/investigation scheduling seeks to provide a solution to thisproblem, to allow access to the right care at the right time in astandardized and efficient fashion.

In the medical field, it is standard to have a primary care physicianoffice fully separate and spaced apart from any specialist physician. Asis standard, a patient will first visit a primary care physician andthen, if required, be referred to a specialist. The patient must thenmake an appointment with that specific specialist, often many monthslater. If desired, the patient must then make a separate appointmentwith another specialist for a second opinion.

As a background in one application of medicine, vascular healthcare isexamined. Cardiovascular disease is a leading cause of death in NorthAmerica and has become a public health epidemic. Cardiovascular diseaseand the associated risk factors are linked to an increased risk ofmorbidity and mortality and are also responsible for escalatinghealthcare costs. Traditionally, if a primary care physician thinks thata patient should be examined by a cardiologist, the patient is referredto a cardiologist and must make an appointment with the cardiologist'soffice, often at an entirely different location. When a second opinionis desired, as is often the case, the patient is again responsible formaking an appointment. This system delays healthcare delivery to thepatient, is time consuming, inconvenient and very costly. Separate EMRs(electronic medical records), and poor information sharing adds to thedysfunctional delivery of care. The current system is highly disjointedand inefficient for practitioners and patients alike.

Typically, a high risk vascular patient must visit several differentspecialist physicians (cardiologist, endocrinologist, nephrologist,etc.), medical laboratories, imaging facilities, a pharmacy, and theirprimary care physician. Usually, each of these encounters occurs atdifferent locations and together comprise basic healthcare. The clinicalinformation from each of these separate encounters is not readilyavailable to the individual healthcare providers and is almost alwaysnot available to the patient. This process results in the patient beingless involved in their healthcare decisions. The patient is furtherburdened with the responsibility of coordinating multiple appointments(and time away from work) to manage their health.

Accordingly, improved approaches are needed within healthcare systems toaddress this epidemic and improve patient education, attendance, andadherence to strategies known to improve health outcomes while limitingfinancial burden. As such, a need exists in an improved medical clinicdesign, enhanced by an improved clinic layout and multispecialty careand integrated technologies suited to optimize the patient's time inclinic, healthcare involvement and overall health outcomes.

Typically, community-based laboratories are separate operationalentities and often in separate locations from medical clinics, typicallybeing in separate building and owned by separate entities. In somescenarios, bloodletting is often done within a clinic but is thenshipped to a centralized laboratory for processing. In a community-basedsetting patients typically visit a laboratory approximately 1-2 weeksprior to a clinic appointment in order to allow time for processing andinformation to be sent to their practitioners to be reviewed at theirclinic appointments. This creates the need for two separate visits forlaboratory investigations and then subsequent clinical assessment bypractitioners. This aforementioned process is inefficient for thepatients and does not allow for immediate same-day results to be used inclinical decision-making. Typically decisions are made based on lab workobtained 1 to 2 weeks prior to the clinic visit. In addition, if thepatient forgets to do their lab work, it is often a less impactfulclinic visit, with the need to subsequently do the lab work after theclinic visit and follow up on the results without the patient present tobe fully informed of their status.

Barriers to having laboratory investigations done on the same visit tothe clinical practitioner are multiple. These barriers include theefficiency and processing of bloodletting from patients, remotelocations of the central laboratory from clinical practices withbloodletting done and samples being shipped to the central location.

Accordingly, a need exists for an improved laboratory physical layoutand process to allow bloodletting to occur within a clinic setting onthe same floor to allow for convenience, efficiency and coordinationwith clinic visits with a separate yet physically connected fulllaboratory outside of the clinic setting in view of the aforementioneddisadvantages.

In the medical field, it is standard to have a primary care physicianoffice fully separate and spaced apart from any specialist physician. Asis standard, a patient will first visit a primary care physician andthen, if required, be referred to a specialist. The patient must thenmake an appointment with that specific specialist, often many monthslater. If desired, the patient must then make a separate appointmentwith another specialist for a second opinion.

As a background in one application of medicine, vascular healthcare isexamined. Cardiovascular disease is a leading cause of death in NorthAmerica and has become a public health epidemic. Cardiovascular diseaseand the associated risk factors are linked to an increased risk ofmorbidity and mortality and are also responsible for escalatinghealthcare costs. Traditionally, if a primary care physician thinks thata patient should be examined by a cardiologist, the patient is referredto a cardiologist and must make an appointment with the cardiologist'soffice, often at an entirely different location. When a second opinionis desired, as is often the case, the patient is again responsible formaking an appointment. This system delays healthcare delivery to thepatient, is time consuming, inconvenient and very costly. Separate EMRs(electronic medical records), and poor information sharing adds to thedysfunctional delivery of care. The current system is highly disjointedand inefficient for practitioners and patients alike.

Typically, a high-risk vascular patient must visit several differentspecialist physicians (cardiologist, endocrinologist, nephrologist,etc.), medical laboratories, imaging facilities, a pharmacy, and theirprimary care physician. Usually, each of these encounters occurs atdifferent locations and together comprise basic healthcare. The clinicalinformation from each of these separate encounters is not readilyavailable to the individual healthcare providers and is almost alwaysnot available to the patient. This process results in the patient beingless involved in their healthcare decisions. The patient is furtherburdened with the responsibility of coordinating multiple appointments(and time away from work) to manage their health.

Accordingly, improved approaches are needed within healthcare systems toaddress this epidemic and improve patient education, attendance, andadherence to strategies known to improve health outcomes while limitingfinancial burden. As such, a need exists in an improved medical clinicdesign, enhanced by an improved clinic layout and multispecialty careand integrated technologies suited to optimize the patient's time inclinic, healthcare involvement and overall health outcomes.

In the midst of a pandemic, what has been lost is the appropriatepractice of medicine. There has been a move to phone assessments ortelemedicine-based assessments. There has been a reluctance to sendpeople to offices are laboratories with busy waiting rooms. It wasunclear how viruses spread initially and any pandemic and the degree ofcontagiousness etc. there is a need to protect both patients andhealthcare staff yet continue to provide appropriate care to patients toavoid complications, emergency room visits and hospitalizations.

Drawbacks of virtual visits including no lab, no imaging and no physicalexamination. Accordingly, a need exists for an improved means forpatient transport, diagnosis and data collection.

SUMMARY

A method of automated medical scheduling including the steps ofreceiving user specified data on a processor via a checklist, said databeing a plurality of predetermined physical conditions of a patient,each of the plurality of predetermined physical conditions having apredetermined assigned weight based on level of severity, generating asummation of the total weight for each predetermined physical condition,generating a predetermined specialty acuity (“SPA”) score by comparingthe corresponding range of the total weight, and using the SPA scoreused to schedule appointments for patients in a system schedule and toschedule sending of an autonomous vehicle sent to the patient forpickup. In some embodiments, a SPA score is generated for each systemaffected, the systems including Cardiac, Renal, Neurological, Vascular,Medical/Metabolic and Pulmonary, each assigned a value of 1 wherein acomorbidity score is generated by the summation of each system. Further,a Total Overall Risk (“TOR”) score is generated by multiplying thesummation of each system by the total SPA scores, generating a report ofthe TOR score, may be provided. The method may further determinefrequency of appointment scheduling, comparing the TOR score to a set ofpredetermined ranges, assigning an appointment interval correspondingwith the TOR score value. Further, an appointment interval is assignedfor ancillary care assessments corresponding to the TOR score value. Insome embodiments, the TOR score is used to determine visit frequency asan amplifier for SPA score passed on physician visits.

In another aspect, an autonomous vehicle for transporting a patient toat least one medical appointment, the autonomous vehicle include aplurality of sensors, the plurality of sensors selected from a group of:cameras, blood pressure sensor, ultrasound, x-ray, EKG sensor, heartsensor, blood sugar sensor, and/or perspiration sensor, and a displaywithin the vehicle, the display providing for virtual communication witha remotely located health care professional. In some embodiments, arobotic arm is positioned within the vehicle, the robotic arm configuredassist in testing the patient. The display may be voice activated. Thedisplay may be configured to accept voice recognition.

The system and apparatus of the present includes an autonomous vehiclespecifically for medical applications and a corresponding system forcoordinating vehicle dispatch and vehicle control. Referring to priorfiled application, the automobile is the inspiration for the unilateralflow design and physical set up upon specific north/south entrances andeast/west exits with clockwise flows through clinic for infectioncontrol. With the inclusion of electric autonomous vehicle, the goal ofa carbon free medical clinic can be achieved.

As discussed in prior applications herein incorporated by reference,solar paneling on roof of copyrighted building plans and use of electricautonomous vehicles for pick up and drop off of patients, controlled bythe electronic operating system. Drop off circle on the outside lanearound building for transportation of patients. Pick up circle on theinside lane around building. Further, both lanes can be clockwise orcounterclockwise or in opposite directions depending on optimalconfiguration for local traffic flow. Drop off at North entrance undermain floor and drop off South entrance through parking garage and canaccess any floor level.

Physical plant will have negative pressure system for the clinic roomsand also for the Electric autonomous vehicles. The scheduling systempreviously disclosed and claimed and is herein incorporated by referenceexplains how multidisciplinary care can be coordinated either physicallyor virtually.

The present apparatus and system provided the virtual component to thephysical plant and software systems. This is the virtual component butit will provide a level of care superior to historical and standard inperson visits, using a novel design of an electric autonomous vehiclefor the purpose of providing robotic assisted remote physicalexamination, imaging and laboratory sampling with the goal oftransitioning to completely virtual assessment (i.e. no need for amedical professional to be present in the vehicle).

Camera systems and EOS technology connected through the car cab has theability to use an autoscope, tongue depressor, swabs etc.

Further, as a transitional phase, these vehicles will pick up patientsand bring them to the clinic for in person assessment. In the absence ofa pandemic, this system still increases efficiency through:

-   -   Preassessment    -   increases time effectiveness for a patient for a visit    -   Increases attendance to clinics    -   Avoids transportation issues and expense and inconvenience        related to such    -   Environmentally friendly and promotes a carbon free environment        and is more inexpensive

These and additional features provided by the embodiments describedherein will be more fully understood in view of the following detaileddescription, in conjunction with the drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

The embodiments set forth in the drawings are illustrative and exemplaryin nature and not intended to limit the subject matter defined by theclaims. The following detailed description of the illustrativeembodiments can be understood when read in conjunction with thefollowing drawings, where like structure is indicated with likereference numerals and in which:

FIG. 1 depicts an exemplary first floor medical clinic layout havingwaiting rooms, a lab, reception, primary care pods, specialist pods,pharmacy, urgent care, and imaging . . . etc. according to one or moreembodiments shown and described herein;

FIG. 2 depicts an exemplary pod (either primary care or specialist)according to one or more embodiments shown and described herein;

FIG. 3 depicts an exemplary building structure with illustrative flowarrows extending therethrough according to one or more embodiments shownand described herein;

FIG. 4 depicts an exemplary building structure with illustrative flowarrows extending therethrough according to one or more embodiments shownand described herein;

FIG. 5 depicts an exemplary building structure with illustrative flowarrows extending therethrough according to one or more embodiments shownand described herein;

FIG. 6 depicts an exemplary building structure with illustrative flowarrows extending therethrough according to one or more embodiments shownand described herein;

FIG. 7 depicts an exemplary building structure with illustrative flowarrows extending therethrough according to one or more embodiments shownand described herein;

FIG. 8 depicts an exemplary exploded view of a single modular pod(comprised of 4 patient exam rooms and a dedicated work space) accordingto one or more embodiments shown and described herein;

FIG. 9 depicts an exemplary exploded patient exam room and dedicatedwork space with access corridors designed according to one or moreembodiments shown and described herein;

FIG. 10 depicts an exemplary screen shots of the computer program modelshowing information inputted by clinic personnel including patientidentification information, problem list, medication list, educationalmaterial, appointments and the QR code generator according to one ormore embodiments shown and described herein;

FIG. 11 depicts an exemplary flow chart of the computer program processof QR code synthesis according to one or more embodiments shown anddescribed herein;

FIG. 12 depicts an exemplary screen shots of the companion mobile deviceapplication model including information accessible to the patient suchas, but not limited to, problem list, medication list, educationalmaterial, and appointment information according to one or moreembodiments shown and described herein;

FIG. 13 depicts an exemplary flow chart of the process of decoding of asynthesized QR code by the companion mobile device according to one ormore embodiments shown and described herein;

FIG. 14 depicts an exemplary building and parking garage layoutaccording to one or more embodiments shown and described herein;

FIG. 15 depicts an exemplary building and parking garage layoutaccording to one or more embodiments shown and described herein;

FIG. 16 depicts a flow diagram for determining a SPA score according toone or more embodiments shown and described herein;

FIG. 16A depicts a continuation of the flow diagram as shown in FIG. 16for determining a SPA score according to one or more embodiments shownand described herein;

FIG. 17 depicts a flow diagram for determining scheduling based on a SPAscore according to one or more embodiments shown and described herein;

FIG. 17A depicts a continuation of a flow diagram for determiningscheduling based on a TOR score which is derived using the SPA and COMscore according to one or more embodiments shown and described herein;

FIG. 17B depicts another continuation of a flow diagram for determiningscheduling based on a TOR score which is derived using the SPA and COMscore according to one or more embodiments shown and described herein;

FIG. 17C depicts yet another continuation of a flow diagram fordetermining scheduling based on a SPA score according to one or moreembodiments shown and described herein;

FIG. 18 depicts a flow diagram of the access and data collection seen bya physician using the program according to one or more embodiments shownand described herein;

FIG. 19 depicts a flow diagram illustrating the administrative accessand data input according to one or more embodiments shown and describedherein;

FIG. 20 depicts a flow diagram the process of fetching all SPA scoresand applying a TOR score to get the actual SPA score according to one ormore embodiments shown and described herein;

FIG. 21 depicts a flow diagram depicting the process of schedulingappointments to determining the best week according to a multiple ofweeks according to one or more embodiments shown and described herein;

FIG. 22 depicts a flow diagram illustrating the option to overrideaccording to one or more embodiments shown and described herein;

FIG. 23 depicts a flow diagram illustrating the lab requisition schedulecreator according to one or more embodiments shown and described herein;

FIG. 24 depicts a flow diagram illustrating an appointment scheduleraccording to one or more embodiments shown and described herein;

FIG. 25 depicts a flow diagram to determine the MRP in each specialtycategory according to one or more embodiments shown and describedherein;

FIG. 26 depicts a flow diagram illustrating the process to determine thefrequency of appointments according to one or more embodiments shown anddescribed herein;

FIG. 27 depicts a flow diagram for generation of a QR code according toone or more embodiments shown and described herein;

FIG. 28 depicts a perspective view embodiment of a patient using a QRcode upon arrival to access parking on the requisite floor of theparking garage and the corresponding scanner to scan their correspondingQR code according to one or more embodiments shown and described herein;

FIG. 29 depicts an exemplary layout according to one or more embodimentsshown and described herein;

FIG. 30 depicts an exemplary screen shot showing an image of thefacility to show a patient where to go according to one or moreembodiments shown and described herein;

FIG. 31 depicts an exemplary perspective view of a user scanning a QRcode to gain access to an elevator to take them to their appointmentaccording to one or more embodiments shown and described herein;

FIG. 32 depicts an exemplary screen shot showing instruction to the userusing a mobile device on where to walk according to one or moreembodiments shown and described herein;

FIG. 33 depicts a screen shot of instructions provided to the useraccording to one or more embodiments shown and described herein;

FIG. 34 depicts a screen shot of instructions provided to the useraccording to one or more embodiments shown and described herein;

FIG. 35 depicts a perspective view of a user using the QR code to accessthe patient room according to one or more embodiments shown anddescribed herein;

FIG. 36 depicts a screen shot of instructions provided to the useraccording to one or more embodiments shown and described herein;

FIG. 37 depicts a screen shot of instructions provided to the useraccording to one or more embodiments shown and described herein;

FIG. 38 depicts an exemplary screen shot of the user management of thesystem according to one or more embodiments shown and described herein;

FIG. 39 depicts an exemplary screen shot of the user management(physician details) of the system according to one or more embodimentsshown and described herein;

FIG. 40 depicts an exemplary screen shot defining SPA scores of thesystem according to one or more embodiments shown and described herein;

FIG. 41 depicts an exemplary screen shot defining categories of thesystem according to one or more embodiments shown and described herein;

FIG. 42 depicts an exemplary screen shot defining categories of thesystem according to one or more embodiments shown and described herein;

FIG. 43 depicts an exemplary screen shot illustrating a checklist of thesystem according to one or more embodiments shown and described herein;

FIG. 44 depicts an exemplary screen shot illustrating the TOR score ofthe system according to one or more embodiments shown and describedherein;

FIG. 45 depicts an exemplary screen shot defining duration of the systemaccording to one or more embodiments shown and described herein;

FIG. 46 depicts an exemplary screen shot defining block times of thesystem according to one or more embodiments shown and described herein;

FIG. 47 depicts an exemplary screen shot defining a calendar of thesystem according to one or more embodiments shown and described herein;

FIG. 48 depicts an exemplary screen shot defining notification of thesystem according to one or more embodiments shown and described herein;

FIG. 49 depicts an exemplary screen shot defining a checklist ofconditions and/or occurrences of the system according to one or moreembodiments shown and described herein;

FIG. 50 depicts an exemplary screen shot illustrating appointmentconfirmation of the system according to one or more embodiments shownand described herein;

FIG. 51 depicts an exemplary screen shot illustrating appointmentoverride of the system according to one or more embodiments shown anddescribed herein;

FIG. 52 depicts an exemplary screen shot illustrating quick consultationof the system according to one or more embodiments shown and describedherein;

FIG. 53 depicts a layout of a lab according to one or more embodimentsshown and described herein;

FIG. 54 depicts a multi-level physical layout of a building whereinlevel 1 includes collection and sorting and level 2 includes transferand processing according to one or more embodiments shown and describedherein; and

FIG. 55 depicts a side view of the autonomous vehicle having a largedoor opening enabling a user to walk through according to one or moreembodiments shown and described herein;

FIG. 56 depicts a screen enabling communication with a patient and chairmovable from a standing to sitting to generally vertical portionaccording to one or more embodiments shown and described herein

FIG. 57 depicts an exemplary view of side interior panels/back interiorpanels with a robotically controlled arm, robotically controlledinstruments that extend to desired position through the aid of camerasand sensors (rectangles), and supplies that can be accesses by therobotic arm (triangles) according to one or more embodiments shown anddescribed herein;

FIG. 58 depicts an exemplary view of side interior panels/back interiorpanels with a robotically controlled arm and robotically controlledinstruments that extend to desired position through the aid of camerasand sensors (rectangles) according to one or more embodiments shown anddescribed herein;

FIG. 59 depicts a flow chart of the system and vehicle apparatusaccording to one or more embodiments shown and described herein.

DETAILED DESCRIPTION

The present disclosure relates to a system and method of determining ascore for the purposes of objectively scheduling patients. The presentdisclosure discloses a multi-specialty clinic, wherein each patient hasa most responsible practitioner health professional involved in theircare. This includes medical specialists (cardiologist, nephrologist,endocrinologist, internist, vascular specialist), primary care familyphysicians, as well as allied health care professionals such as nursepractitioners, pharmacists, dieticians, social workers etc.). Aplurality of factors are considered and scores are determined tocalculate, from a objective standpoint, which patients to give priorityto, and standardized scheduling frequency according to overall riskstatus across multiple specialties.

The present specification discloses a medical clinic layout including awaiting room, reception area, modular clinic pods, patient exam rooms,physician workspace and collaboration area, pharmacy, laboratory, urgentcare, imaging . . . etc. along with corresponding flow arrows toillustrate the optimization of the medical clinic layout's efficiency.The present application includes a unique physical and operationaldesign for a vascular health clinic, by way of example. It should beunderstood that the present clinic layout can apply to various differenthealth specialties and practices and is not limited to vascular health.These components are specifically fashioned to work synergistically toincrease the efficiency of healthcare delivery and improve healthoutcomes, while also moving away from provider-centered care topatient-centered care. The design also minimizes the area required toprovide multidisciplinary and multi specialty healthcare.

The design of the present specification is configured to eliminate thefundamental problems, as previously described, with the currenthealthcare model. Patients will have access to their primary carephysician, a select group of vascular health specialists, includingcardiology, nephrology, endocrinology, neurology, and vascular surgery(available on-demand for ‘quick’ problem specific consultation), amedical laboratory, imaging, diagnostics, and pharmacy services, all atthe same location, and in the same visit. A corresponding computerapplication and companion mobile device application are also provided.

By implementing the below described design and utilizing thecorresponding computer program and companion mobile device application(as described in the parent), healthcare providers will be able toincrease the efficiency and quality of healthcare delivery, facilitateand simplify coordination of care, enhance patient involvement inhealthcare and measure and improve health outcomes in patients withvascular disease through clinical evidence-based strategies. Byimplementing this complete design, a new gold standard of healthcarewill be achieved.

Referring now to FIG. 1 , the exemplary clinic layout 100 is generallyrectangular or square in shape, having a main outer perimeter 102. Thelayout 100 includes a four corners design for ancillary components ofthis unique clinic design, with clinic space centralized between thesecomponents. This allows for more efficient coordination ofmultidisciplinary and multispecialty services and allows these servicesto be provided in one location, within a smaller footprint. The fourcorners include an urgent care space 104, a lab 106, an imaging center108, and a pharmacy 110. The layout further includes two main entrances112 and 114. The main entrances 112 and 114 include a waiting areas 124and reception desks 128. Both main entrances 112 and 114 allow patientsaccess to their desired service, either main clinic or ancillaryservices. This design provides patients with isolated and integratedcare and utilizes unidirectional patient flow to increase healthcaredelivery efficiency. The outer perimeter 102 of the layout 100 furtherincludes exits 101A and 101B, which are configured to be exits only. Inthe present embodiment, the entrances 112, 114, are configured to beentrances only. The entrances and exits are stationed to be polaropposite sides of the structure, as located at 101A, 101B.

A medical clinic 100 is provided having a waiting room 102, reception112, a lab 104, a plurality of primary care modular pods 106 (a pod iscomprised of 4 exam rooms, a central workspace and collaboration stationand access hallways), practitioner modular pods 108 (a pod is comprisedof 4 exam rooms, a central workspace and access hallways), a pharmacy110, entrance 120 and exit 122.

The urgent care space 104 includes an enclosed space set up similar tothe primary care and specialty care pods. The urgent care space includesa center hallway 154 where care providers work. Patients are notpermitted in the center hallway 154. A plurality of exam rooms 152 arepositioned adjacent to the hallway 154. Each of the exam rooms 152include two doors. One of the doors 150A is a dedicated door forpatients. The other door 150B is a dedicated care provider door.Patients are not permitted to pass through the door 150B.

The lab 106 includes a lab reception area 106A where patients check in.The lab is an area where care provides can collect and test samples frompatients including urine, blood . . . etc. Areas 106A, 106B includesexam rooms and bathrooms for sample collection spaced apart by ahallway.

The imaging center 108 includes a plurality of rooms for x-ray andultrasound as shown at 160, 162. The imaging center includes two doors,both near reference numeral 108A to facilitate patient flow through theimaging center.

The pharmacy 110 includes a door 110A located near both a side exit anda main entrance so as to facility patient flow through the pharmacy.

The layout 100 further includes a plurality of primary care pods 130 andspecialist pods 132. Each of the pods 130,132, as illustrated in FIG. 2, include a plurality of 8 exam rooms 170 each having a patiententrance/exit 180 and a care provider entrances/exit 182. The hallway172 and the care provider space 174 is only accessible by the careproviders, doctors, nurses . . . etc. The hallway 172 and the careprovider space 174 shall not be accessible by any patients. The specificlayout prevents unwanted interaction between care providers and patientsby keeping the spaces that each party walks and moves separate. Thepatients go in and out of one door (180) and the care providers only goin and out of the other door (182). This specific layout preventspatients from overhearing care providers discussing the files andconfidential information of other patients since only care providers arepermitted in the hallway 172 and the care provider space 174. Each ofthe exam rooms 170 may further includes screen 161 and examtable/reclining chair 156.

It should be noted the layout 100 is nearly exemplary and not intendedto limit the scope of the present invention. The layout 100 mustcomprise four corners and a plurality of pods, although the exactconfiguration, such as shown in FIG. 1 , is not required and thespecifics of each area may be adjusted in accordance with communityneeds.

FIGS. 3 through 7 illustrate exemplary paths taken by a patient whenvisiting the clinic 100. FIG. 3 depicts a patient path 200 wherein thepatient enters the main entrance 112 and continues through the waitingarea 124. After visiting reception 128 the patient moves to theirdesignated primary care pod 130. The patient may then utilize thepharmacy 110 before exiting 122. Movement of the patient along thepatient path 200 facilitates unidirectional patient flow through theclinic—in many variations this flow is clockwise throughout the clinic.The patient path 200 facilitates patient movement from the entrance 112to one of the dedicated exits, in this embodiment, exit 101A, so as toincrease clinic operational efficiency. This is further facilitated bythe electronic standard adopted by the clinic, ensuring there is no needfor patients to backtrack at any time, facilitated by a 3D rendering ofthe path to take through the clinic by the companion phone application.

FIG. 4 depicts an exemplary patient path 202 wherein the patient is onlyvisiting the clinic to visit the pharmacy 110. In this embodiment, thepatient enters the main entrance 114 and visits the pharmacy 110 beforeexiting the dedicated exit 101A.

Referring now to FIG. 5 , a patient path 204 is provided wherein thepatient enters the main entrance 112 into the waiting room 124. Aftervisiting reception 128, the patient proceeds to a primary care pod 130.If needed, a specialist can be ‘quick’ consulted, and will come to thephysician workspace using the clinic flow pattern and 3D rendered pathto the desired consulting practitioner's pod entrance and workspace.Here the case can be discussed confidentially and if needed theconsulted practitioner can enter the patient's exam room, providingpatient-centered care. In the route as shown in 204, the patient thenvisits the specialist 132 in the same visit, or the specialist comes tothe patient. The patient may then proceed to the lab 106 before exitingthe building 101B.

FIG. 6 depicts a patient flow path 206 wherein the patient enters theclinic at the main entrance 112 and proceeds through the waiting room124. After visiting reception 128 the patient proceeds to a primary carepod 130. The patient then visits the imaging center 108, and if needed,a specialist can be ‘quick’ consulted to see the patient in the imagingcenter, which will house additional pods, and patient exam rooms. Thepatient then exits the clinic at the dedicated exit 101B.

FIG. 6 further depicts a path at route 206. This route show the path ofa person moving between exam rooms and through the hallway. The hallwayextending between 104A and 104B is created to provide a path forphysicians (and other staff) only and is intended to be a private andconfidential area.

Referring now to FIG. 7 , a patient flow path 208 depicts wherein apatient enters the building through a main entrance 112 into the waitingroom 124. After visiting reception 128, the patient may visit the urgentcare 104 and exits the building through the dedicated exit 101A.

In some embodiments, a second and third floor may be provided on top ofthe first floor as illustrated in FIGS. 1 through 7 . These additionscan be added or omitted in a modular nature to suit geographicalcommunity needs. Similarly, a modular floor may be added for teaching,conference and private office use as needed. In order to provideadequate parking, while minimizing the facility's overall footprint, aparking garage will be available adjacent and connected to the mainfacility. The parking garage and elevators will provide multi-flooraccess to the main facility. The additional floors may include officesand a renal program/dialysis center accessible via the parking garageand elevators.

The clinic's lab will be available for immediate blood drawing prior tothe patient's appointment. Analysis of the blood sample will takeapproximately 10-15 minutes and results will be electronically inputtedinto the clinic's EMR (electronic medical record). The results will beavailable to the healthcare provider that same day for assessment. Thissaves the patient a visit to separate medical laboratory, which iscommon practice, usually done one week prior to their clinicappointment.

Now referring to FIGS. 8 and 9 , each of primary care modular pods andthe specialist modular pods include a centralized work area surroundedby four exam rooms, giving the provider(s) easy access to each exam roomthrough the access hallways. Each of the exam rooms 1150 has a separateentrance/exit for the provider 1158 and a separate entrance/exit for thepatient 1160. The provider also has a separate entrance/exit 1154 to thework area 1152. The plurality of entrances and exits (as shown by theplurality of doors in FIGS. 8 and 9 ) for the patients and physiciansoptimizes efficiency of the modular pods, and therefore the entiremedical clinic. Each of the exam rooms in the clinic arecompartmentalized, patient-centered, and facilitate a collaborationbetween healthcare providers and patients. Each exam room will have aunique and uniform design.

The pods are positioned adjacent to one another. Each of the pods has ahallway extending therethrough to optimize movement of healthcareproviders between exam rooms, and to enable specialist physicians fromother pods to easily access the pods 1106 for ‘quick’ consultation.

The joint specialist pods contain at least two work spaces forphysicians. The dual workspace configuration allows two specialists towork directly adjacent to one another, allowing optimization of patientcare. If, for example, the patient or physician wants a second opinion,a similarly specialized physician is available to immediately provide asecond opinion. This method of providing second opinions can be appliedto the primary care physicians as well. All physicians, both primarycare and specialist, can utilize the centralized hallways connecting thework spaces and enter through the physician entrances, to increaseefficiency of movement throughout the clinic.

Each exam room will have a dedicated area for the use of audio/visualpresentation 1161 (FIG. 9 ), which allows the patient to see theirlaboratory values, imaging results, and question their healthcareprovider with any concerns. This design allows the patient to be moreinvolved in their healthcare decisions, and more informed about theircondition. The audio/visual presentation 1161 (FIG. 9 ) will displayeducational material while the patient waits for the physician in theexam room. The use of audio/visual technology 1161 (FIG. 9 ) is alsointegrated with the use of the novel computer program and companionmobile device application. When a healthcare provider generates a QRcode using the computer program, it will be displayed on the projectionarea for the patient to scan using the companion mobile deviceapplication.

The patient will scan the QR code giving them access to their problemlist and educational materials, such as outlined and described in theforgoing description of the computer program and companion mobile deviceapplication. The QR code may also open a link to download/viewadditional information critical to the patient and patient care. Theexam room will contain a single swivel, reclining examination chair inthe center of the room, as well as a rolling chair for the attendingphysician. Other components standard and necessary in typical exam roomsmay also be provided.

The medical clinic may also be equipped with a paging system as a backupsystem, to facilitate the ‘quick’ consult model, however this willroutinely be done through the clinic software and phone application. Ineach exam room audio/visual educational material will be displayed onthe screen 161 until the physician arrives. In this embodiment, thescreen 161 is contained within the exam room. The screen may be anydisplay screen, such as a monitor, projector or television, suitable toprovide the relevant information to the patient.

In one aspect of the present specification, a means for enablingcommunication within the medical clinic regarding the occupancy of examrooms is provided. The computer program will have a secure login for allclinic personnel (both support staff and healthcare providers). Thisfunction of the computer program can be described as a flow manager andwill also facilitate the novel ‘quick’ consult model. This function willbe available from the computer program home screen and when accessed canproject to the screen. This screen will be accessible to all clinicmembers (both support staff and healthcare providers). By clicking thepictorial representation of an exam room, a clinic member will have theoption to change the occupancy status of that exam room. The statusoptions are: empty, filled-ready for nurse, filled-ready for doctor,filled-patient and doctor. The exam room statuses are color coordinatedto make the status of the exam room visually detectable by clinicpersonnel. When an exam room's status is changed, the computer programwill notify appropriate clinic personnel in two ways. The firstnotification method is a pop-up desktop notification, and the second isa mobile device notification. Combined, the flow manager, andnotification systems will maximize clinic efficiency.

The next novel component of the flow manager is making the ‘quick’consult model practical and functional. A healthcare provider will beable to select an exam room where they would like a colleague'sconsultation. Once the room is selected, a specific provider can bechosen for consultation. The provider chosen for consultation will thenreceive notification via the computer program in the form of a desktopnotification and a mobile device notification. The practitionerproviding the quick consult can navigate to the desired location usingthe 3-D rendered paths that are consistent with the flow patternsestablished for the clinic.

The computer program and companion mobile device application, such asillustrated in FIGS. 10-13 , are essential to accomplishing the goals ofthe medical clinic by increasing productivity and improving patienthealth outcomes. The computer program and companion mobile deviceapplication work together to enhance coordination of care, increasepatient involvement in care, while also providing helpful educationalmaterial, and simultaneously integrating clinic design with noveltechnology such as described herein and above. The problem list,medication list, educational material, appointment information andreminders will also be instrumental in increasing patient involvement,medication adherence and patient appointment compliance. These featuresare available to the patient through the companion mobile deviceapplication on the patient's personal mobile device. A detailedexplanation of each component is found below.

FIG. 10 illustrates the general interface of the computer program forhealthcare providers and medical clinic personnel. FIG. 10 generallyillustrates exemplary screen shots of the computer program. The firstscreen 1300 includes general biographical information such as the dateof birth, address . . . etc. of the patient and accessible functionssuch as problem list, medication list, education, and appointments. Thisinformation is inputted by the physician or the medical clinicpersonnel. Screens 1302, 1304, 1306 and 1308 all illustrate areas forthe healthcare team to input information such as the problem list,medication list, education and appointments, respectively. Screen 1310illustrates the QR code 1254 generator.

FIG. 10 shows a general layout of the computer program, in which eachclinic patient will have a profile with basic identification information(name, DOB, gender, address, phone number, health coverage identifiers .. . etc.). Within each profile, one of four functions can be accessed1300. The functions include the problem list 1302, medication list 1304,education 1306, and appointments 1308. As described below, within eachof these four categories, information can be selected/inputted by thehealth care team that is specifically suited to each patient. Once theinformation is inputted by the appropriate personnel, the information issaved to the patient's profile allowing a QR code to be generated andscanned by the patient via the companion mobile device application onthe patient's personal mobile device. Once scanned the patient will haveaccess to information and reminders that will increase patientinvolvement and improve health outcomes.

FIG. 11 illustrates a general process in accordance with the computerprogram QR code synthesis 1200. The problem list 1202 is inputted by theprovider to grant the patient a current, inclusive problem listavailable to the patient on their personal mobile device via thecompanion mobile device application. The provider inputted problem listwill computationally be translated to the appropriate, currently usedICD-10 (International Classification of Diseases) codes. This process isillustrated beginning at reference numeral 1202. An example of ICD-10codes are provided in the flow chart of FIG. 11 at reference numeral1212. The selected problems are inputted and converted to ICD-10 codes,then they are combined 1214 (as illustrated by the directional arrow)into the numerical code 1250. This numerical code 1250 is generated 252into a QR code 1254, such as shown.

FIG. 11 further illustrates the education 1204 selected by the physiciangranting the patient access to the corresponding educational material ontheir personal mobile device via the companion mobile deviceapplication. The educational material is selected by the physicianspecifically suited to each patient. All distinct educational materialwill have an assigned numeric value as shown in reference numeral 1220.Reference numeral 1222 illustrates an example of these assigned numericvalues. The provider selected educational material are computationallytranslated to their numeric value and combined 1224 (as illustrated bythe directional arrow) into the numerical code 250. This numerical code1250 is generated 1252 into a QR code 1254, such as shown.

A medication list 1206 is further provided as inputted by thepharmacist, granting the patient access to their medication list andcompliance reminders on their personal mobile device via the companionmobile device application. As illustrated by reference numeral 1230, themedication list is formulated using DIN (Drug IdentificationNumber—Canada) and NDC (National Drug Code—USA). These codes give thedrug, strength and form. The quantity, dosing frequency, route ofadministration and refills may also be added to this information. Anexemplary set of codes is provided at reference numeral 1232 showing anexemplary drug, strength, form, quantity, frequency, and refills . . .etc. The pharmacist will input the medication list which will becomputationally converted into a unique numeric code and combined 1234(as illustrated by the directional arrow) into the numerical code 1250.This numerical code 1250 is generated 1252 into a QR code 1254, such asshown.

FIG. 11 further illustrates the appointments 1208 are inputted by thephysician or support staff and viewable by the patient on their mobiledevice via the mobile application. As illustrated at reference numeral1240, appointments are broken down into type, time, day, month and year.To generate the QR code 1254, each parameter of the appointment iscomputationally assigned a numeric value. An exemplary set of numericvalues is illustrated at reference numeral 1242. The appointments areinputted and computationally converted into a unique code and combined1244 (as illustrated by the directional arrow) into the numerical code1250 This numerical code 1250 is generated 1252 into a QR code 1254,such as shown.

Collection of data as outlined above and as outlined in FIG. 10 and FIG.11 allows the computer program to generate the QR code 1254 that isreadable by the companion mobile device application. The QR codes 1254are made available to the patient in the exam room, at reception, or inthe pharmacy, electronically or in any way deemed effective andefficient.

FIG. 12 illustrates the general user interface of the companion mobiledevice application. Screen 1400 having the button 1412 (to enable thecamera to capture the QR code). Screen 1400 also enumerates theselectable options of problem list, medication list, education,appointments or contact us. Screen 1402 illustrates the problems list,screen 404 illustrates the medication list 1404, screen 1406 illustratesthe educational material available to the patient, screen 1408 depictsupcoming appointments and screen 1404 shows contact options.

The companion mobile device application utilizes the camera function 412in virtually all mobile devices to read the QR code 1254. Upondownloading the companion mobile device application, the patient will beable to scan the QR code 1254 provided to them by clinic personnel. Thecompanion mobile device application will open with the camera functionenabled. The user can tap the circle 1412 while the camera is in view ofthe QR code 1254 to allow for QR code decoding. The companion mobiledevice application will automatically populate with the information(problem list, medication list, educational material, and appointments)attached to that unique QR code. The information previously translatedinto the QR code 1254 will be accessible to the patient within thecompanion mobile device application. The companion mobile deviceapplication will subsequently provide helpful reminders for medicationadherence, medication refills, and appointments. The companion mobiledevice application will access the devices' notification system andremind patients of upcoming appointments 7 days, 3 days, and 1 day priorto their appointment. This allows for more efficient use of office stafftime by eliminating the need to make appointment reminder calls, whileenhancing appointment attendance. The application will also providemedication adherence reminders. The reminders will be specific to thedrugs and medication schedule that the patient is prescribed. This willimprove adherence to therapies known to improve patient health outcomes.Furthermore, the companion mobile device application will have afunction allowing the patient to contact the clinic via email 410. Thisfunction will be stratified, allowing the patient to select the generalpurpose of their inquiry. Each selection will open a template email andallow the patient to send their comment/question/concern to ageneralized email account(s) and include their phone number forcorrespondence. Emails will be sorted by importance and urgency, andpromptly responded to accordingly. The companion mobile deviceapplication will eventually be developed to allow the patient to tracktheir home health information, such as blood pressure, blood sugarreadings, etc. and pertinent clinical laboratory parameters. That samepatient-specific QR code For that visit, will allow access for thepatient to the physical plant at the parking gate and allow touchlessentrance Into elevators, interior and exterior entrance doors and Clinic3-D navigation systems. For any visit, the generated QR code will allowaccess for the patient to the physical plant at the parking gate andallow touch less entrance Into elevators, interior and exterior entrancedoors and Clinic 3-D navigation systems.

Score Generation and Objective Scheduling

Referring now to FIGS. 16-26 , score generation and calculation isdescribed in detail. A comorbidity score is generated as a first step inthe present system. A processor generates a comorbidity (COM) scorebased on a number of different inter-related systems that add to apatient's overall morbidity in either additive or exponential fashion.An example in the cardiovascular system would be the combination ofproblems such as those known to contribute to cardiovascular diseaseburden. The presence of multiple involved systems (cardiac, renal,neurological, vascular, medical and metabolic and pulmonary) that arelisted in their standardized problem list that is used for all patientsacross all specialties, are used to generate a COM score.

At the time of each assessment or review of status by the mostresponsible practitioner in each field (for both primary care andspecialty care), a specialty acuity score is generated (by practitionersin each field involved in the patient's care) from 1 to 6 based on theirlikelihood of needing to use the emergency room or requiring a hospitaladmission. This specialty acuity score is based on having zero or moreof the multiple clinical features in each specialty selected from astandardized checklist for each specialty most predictive of a poorprognosis reflective of a higher likelihood of requiring emergency roomassessment or hospital admission. A Speciality Acuity (SPA) Score isthen generated (as illustrated in FIGS. 16 and 16A).

Referring now to FIGS. 16 and 16A, a process of determining a SPA score,a COM score and a TOR score is herein described. As shown in FIGS. 16and 16A, the process starts by entering data including neurological,vascular, medical or metabolic, renal, cardiac or pulmonary. By way ofexample, we look to the process for cardiac SPA score determination.Based on data input into the system, in the format of a checklist, thetotal weight is determined. in the embodiment as illustrated in FIG.16A, the total weight for this individual is 16. The system thenproceeds to compare the total weight with a predetermined factor todetermine the SPA score. Once the SPA score is determined, thecomorbidity score can then be determined. It should be noted that theterm comorbidity is abbreviated in this specification COM. The Tor scoreis then generated by multiplying COM score by the sum of the SPA scores.This TOR score can be used to determine scheduling and overall health orurgency of a patients visit.

The SPA score used by each most responsible primary care and specialtypractitioner involved in the patient's care will be standardized. It isbased on the presence or absence of the most predictive signs orsymptoms of poor prognosis and the potential need for emergency room useor hospitalization within a few days to up 6 months (or more). Theseprognostic features will be weighted for impact and will be based on themost up to date data and clinician consensus within that field and canbe adjusted as new data becomes available. This some of the weightedprognostic features will factor into determining the SPA score categoryfor that patient as illustrated below.

The SPA score for a predetermined field is used to determine astandardized scheduling frequency in the clinic for stable patients tosee their primary care and specialist practitioners at regularoverlapping intervals. The computer program will then create quickconsult appointments for those specialties as mandatory for anyspecialty with a SPA of > or =5 as well as to meet the standardpredetermined requirements described above. At any visit, based onclinical judgment, a quick consult can be obtained by request to anyother area of specialty. The program will differentiate whether thequick consult is due to high acuity score or required routine follow upor by a clinical judgment request.

The comorbidity (COM) score is multiplied by the sum of the specialtyacuity (SPA) scores to calculate a total overall risk (TOR) score.

TOR=COM(ΣSPA)

The TOR score will be utilized in a standardized fashion to facilitatenurse practitioner and allied health care assessments for high riskpatients as well as a SPA score multiplier for medical practitionerassessments to reflect the priority of more complex patients withmultiple medical problems co-existing.

The higher the TOR score, the earlier follow-up will be booked in astandardized fashion with allied health care and priority specialtiesbased the highest SPA scores to give priority to those patients needingcare faster in an objective manner. For any given specialty there willbe regularly scheduled follow-up based on the specialty acuity (SPA)score. Based on priority, the most immediate follow up is objectivelybooked by the specialty who has the highest SPA score. If more than onespecialty has the same SPA score for the patient, they are booked withthe specialty who has the highest weighted score from the standardizedchecklist factoring into the SPA score. The patient will be given 3options for booking with their MRP specialist with the highest SPA scorewho is available at the patient's preferred booking time and the otherspecialist(s) will be automatically quick consulted. Any acuity score of5 or clinical judgement, generates an automatic quick consult to anyother specialty. Clinicians can override and ask for a quick consult atany point in time regardless of risk score if there is a concern.

The Program and Role of Each Most Responsible Practitioner (MRP)

Most patients prefer to maintain oversight of their care with their mostresponsible practitioner (hereinafter referred to as “MRP”). Thescheduling method and system of the present specification will searcheach MRP's schedule to try and book each follow up by priorityassignment with that specific MRP and try and match the highest acuityscores to ensure as many MRP's that are present in the clinic at theirsuggested booking times based on their highest acuity scores. If at thattime the patient needs an assessment by a specialist physician that isnot their MRP, this can be done by a covering practitioner but the MRPwould be responsible for approving any changes. All investigations ororders on any patient of are always sent to their MRP for review andapproval if they are available. If urgent or the MRP is unavailable, thecovering practitioner in that specialty will approve theinvestigations/orders.

In some embodiments, a patient can book with any practitioner with thesame priority SPA score that is available at the time they are able toreturn. This process gives complicated patients multiple options forrebooking. The computer system and method coordinates these bookingsbased on searching the schedules of their most responsiblepractitioners. If none of their highest SPA score practitioners areavailable, they can book with the next available practitioner in thatspecialty, but all information must be reviewed and approved by theirMRP. All changes made by any practitioner who sees them by quickconsultation who is not their MRP must be approved by their MRP in thatarea and the computer program coordinates this. This allows shared carebut accountability directly to the patient by their own family doctorand their own specialist practitioners.

EMR Program Laboratory/Investigations Coordination

The system and method of some embodiments organizes both statlab/investigation and routine lab/investigation scheduling to avoidduplication of tests and multiple visits to the lab or imagingfacilities. The frequency of visits based on the TOR/SPA scores andclinical judgment will be at 1 day, 2 days, 4 days, 8 days, 2 weeks, 4weeks, 8 weeks, 16 weeks, 32 weeks, 64 weeks. The system and method ofsome embodiments will generate a single lab/investigation list based onthe requests of all practitioners for that patient and the timeintervals for each practitioner's routine follow up frequency (alsodetermined by the program based on that specialty's SPA scores) andgenerate a single set of tests to be done before each visit with copiesto go to all practitioners involved in the patient's care for review.The verification of routine investigations is required by all mostresponsible practitioners involved in the patient's care. Any STATlabs/investigations can be entered at any time based on the needs of thepatient and are copied to all practitioner's involved in the care of thepatient. The responsibility for verifying STAT labs is with the orderingpractitioner. The program will differentiate between STAT investigationsand routine investigations when sent to a patient's practitioners.

The above is combined with lab/investigation appointment and schedulinginto the same system and method.

Patients investigations done at the single-site multi-specialty clinicare done the same day/visit. The program (EMR) coordinates thescheduling to provide the same day clinic visit with investigationsperformed in the lab and imaging facilities on the same day prior to thescheduled visit.

The specialty with highest priority SPA score gets the primary bookingwith other specialties available that may or may not be their MRP inthese areas, but their MRP must approve any changes.

This program can be used across sites and can determine the need forvideo conferencing from remote sites for specialty or primary carebookings at different locations as long as the program (EMR) is sharedacross these locations.

Multi-Disciplinary Allied Health Care Booking

In most outpatient clinical settings, the use of allied healthcareprofessionals such as dietitians, pharmacists, social workers, etc., arenot used on a priority basis and funding formulas for their use do nottake into account patient care needs in a standardized fashion, nor arethey shared across clinical specialties in a multi-specialty clinic.

FIGS. 17-17C Depict a flow chart for scheduling based on the TOR and SPAscores determined in the aforementioned. FIG. 17 depicts schedulingafter medical practitioners input specialty morbidity items via achecklist into the EMR system. If in SPA is score is greater than orequal to 5 for any system, a quick consult may then be scheduled.Looking now too FIG. 17A, if the TOR score is between 0 and 9, by way ofexample, the practitioner then involves the patient's MRP primary MD orallied health care professional as needed via quick consultation andsaid patient receives notification to review and assess as needed.Referring now to FIG. 17B, the appointment frequency for nursepractitioner and allied health practitioners is determined based on theTOR score. As illustrated, the higher the patients TOR score, the morefrequently a regular appointment will be scheduled. As illustrated, thehigher the patients TOR score, the more frequently a regular appointmentwill be scheduled.

Referring now to FIG. 18 , the physician is a user type that has theability to view patients, view all patients registered in the system,view patient details, history and medical notes. The physician also hasthe ability to view schedules by daily weekly or monthly arrangements,and view appointments and appointment details to confirm checklistsschedule follow up appointments override follow up appointments and getquick consultations. The physician may also be notified if the patienthas been served by the covering physician.

FIG. 19 Depicts the administrative panel for input and checkinginformation. The admin is a user type that has administrative featuressuch as: view all physicians, view physician details, schedules,patients, view all patients including their information, view MRPappointment details, change SPA duration, Change TOR values configurechecklists and add weights and configure lab requisition.

FIG. 20 depicts application of the TOR score. The Tor determines theoverall risk of the patient. This is calculated by factoring in allindividual risks from all specialties. the higher the TOR score, thequicker a patient may need to see a specialist.

FIG. 22 depicts appointment scheduling. The objective of this process isto determine the best week that the appointments can mesh together ifmultiple appointments are required, and to generate options for thepatient/provider to choose from. The process checks by the highestpriority SPA score as all other appointments are a multiple of thehighest requirement. The system then automatically schedules anappointment of the highest priority appointment. The other appointmentswill all then fit into the highest priority appointment time slot. FIG.22 depicts potential override by the physician. In the case thephysician needs to override an appointment, they will have to select theappointment time from the standardized TOR and SPA booking options. Thiswill allow the other appointment to be stacked with the appointment.

FIG. 23 depicts the lab requisition schedule. The objective is toschedule all lab requisition appointments together wherever to minimizeblood drawing and duplication of tests. The objective is to get all nonurgent lab requisitions within a defined period, such as within fourweeks, of the most urgent appointment to be drawn at the same time. Asillustrated by the series of steps, if the patient has in SPA score offive, all SPA 4 lab work is combined to the required lab requisition atSPA 5 visit.

FIG. 24 Depicts additional scheduling. Once the preferred week isdetermined, the system will mesh the appointments together according tothe weekday and availability of physicians. The system will check forthe total number of appointments to be scheduled for that day accordingto TOR based nurse practitioner led allied health assessments. Thesystem then views the highest priority appointment by the SPA score andstart viewing to see if an assessment block is available on thephysicians calendar. If more than one SPA score is the highest, it willevaluate weights as applied to the SPA score and consider the highestweighted sum as the priority specialty to book with. Once the highestpriority SPA appointment is booked, the others will be automaticallyscheduled within the same block slot. If this system determines that aTOR based Nurse Practitioner led Allied health care assessment is alsorequired, It will automatically be booked in the time slot immediatelypreceding the SPA based physician appointment. The system then willperform the same steps for two other appointment blocks in the same weekto show alternative appointment options to the patient.

FIG. 25 depicts the determination of the MRP in each specialty category.After every assessment a script will run to determine if the physicianis the MRP. If the physician is not the MRP, the MRP will receive anautomated notification that their patient has been addressed. Eachpatient at the facility has a MRP nurse practitioner and allied healthas well as physicians and each of these categories have coveringpractitioners for the same time they are away. However, all assessmentsdone by back up must be approved by the MRP. Further, each patient has aconsistent MRP nurse practitioner and allied health practitioners thatcoordinate with the primary care physician at all times to avoid siloedmultiple allied health care assessments from individual specialties.There is consistent nurse practitioners allied health care team acrosscovering the primary care practices. This system provides for a trueintegrated collaborative community based care that is not siloed withregards to nurse practitioners and allied health care nor physicianmulti care specialty care and allows for in person or virtualassessments.

Current practice employees allied health care disciplines withinindividual practices and are not shared by multiple practitioners at asingle site. Therefore, patients may see multiple dietitians, pharmacistor allied healthcare professionals depending on which specialist orprimary care practitioners they are visiting. In addition, currentmodels are not standardized or efficient to match patient care needs ina priority fashion.

The system and method of some embodiments can be used as well forpriority booking with allied healthcare professionals in amultidisciplinary setting with the same MRP (most responsiblepractitioner) model, TOR scores and procedures as outlined above toprioritize assessments and provide consistent and efficient care andoptimal utilization of shared resources, while still being co-ordinatedwith medical appointments as well.

With regards to TOR scoring for allied healthcare, the higher the TORscore, the greater the need to allied healthcare support, led by a nursepractitioner, who tailors other allied healthcare involvement to theneeds of the patient and can quick consult other allied healthcarepractitioners, and reviews these assessments with the primary caredoctor for that patient. Through this process, the primary care SPAscore can be adjusted or quick consultation with any other specialty canbe obtained also.

One of the main clinical advantages of this program (EMR) is that itforces the practitioner at each clinical interaction to focus on theacuity and priority needs of each individual patient while at the sametime ensuring that their chronic ongoing comprehensive care is alsolooked after in a standardized fashion. We believe that comparativeresearch done in this regard compared to standard care will show animprovement an emergency room utilization and hospital admission rates.

This program features described are intended to be used as the frameworkfor a multispecialty and multidisciplinary integrated clinic EMR systemthat can be used separately or tailored to be compatible andcomplimentary to existing EMR systems. An independent EMR system can bedeveloped with the above-mentioned program, or components of thisprogram can be used to compliment and integrate with existing EMRsystems already in use.

The system described herein is intended to be a one-stop-shop for allprograms used by medical facilities also incorporating the physicallayout of a medical building. Just as the clinic design is a one stopshop for multiple disciplines and specialties, the electronic operatingsystem of the clinic should also be a one stop shop. Traditional clinicshave an electronic medical record that is limited in function topredominately house patient and scheduling information. This system willnot only be an electronic medical record, but will be an operationalsupport system for the entire function of the clinic to be accessedthrough a single program.

An EMR application will be provided on a mobile device. The EMRapplication will be a 1) Quick Consult (quick consult) tool; 2) locatingand paging system; 3) Ride request tool; and 4) Scheduling remindertool.

The present system houses patient information and features a completelyunique integrated scheduling program across multiple disciplines andspecialties but will also incorporate a complete operational supportsystem as well. As an operational support system, this system will actas a locating system for contacting or finding the location of anyprofessional staff member or patient within the clinic. This willreplace the need for separate paging systems.

This system will have a built-in capability to connect autonomouselectric vehicles to allow pick up and drop off for patients from theirhomes as well as for staff members to be brought to the clinic and totheir home. There will be a confirmation mechanism to notify clientsjust prior to pick up connected through their smartphones. The systemwill connect to autonomous electric vehicles to allow pick-up from homeand drop off at the most appropriate entrance and subsequent pick up andexit. This is utilized for both staff and patients. A path may follow acircular path around the building. Various advantages include: 1) a“green” and environmentally friendly solution; 2) eliminates parkingneeds; 3) eliminates transportation issues; 4) immediate pick-up anddrop-off; and 5) provides for wheelchair accessible cars. The parkinggarage may be used to access the various floors, such as shown in FIGS.14-15 .

The physical layout of the building and the surrounding internal road aswell as the set-up of the parking garage allows for pick up and drop offat designated entrances and exits. All entrances are from the north andsouth and all exits are from the east and west to allow a coordinatedsystem for pick up and drop off at the building.

The ground floor map of the physical plant layout surrounding thebuilding illustrates the flow pattern of vehicles around the building.The multilevel parking garage with entrances at the south end will allowfor easy drop off for autonomous vehicles.

The use of autonomous vehicles coordinated with the clinicsmulti-functional electronic medical record and operational supportsystem will allow for transportation to and from the nearest emergencyroom for patients who need to attend the hospital but do not require anambulance with Appropriate protocols in place

The system as described herein may also track outcome data. The systemwill calculate target indicators for quality based outcomes and assignsa score to each MRP involved in care for incentive bonuses for qualitycare. This data is tracked and assigned in the program itself.

Overall, the system includes:

-   -   Payroll    -   Billing and Expense Calculation    -   Transportation (to/from)    -   EMR    -   Scheduling    -   Location & Paging    -   Quick Consultation    -   Target Outcome Data for Quality Care Incentives    -   Satisfaction surveys    -   Radiology booking    -   Pharmacy (order entry/counseling)    -   Lab (direct information)    -   UC (visits, scheduling)

The system as described herein is particularly advantageous in that itis a green solution in the face of an increasing climate crisis,eliminates parking and the physical design of the building allows forparking garage space to be converted to clinical space, eliminatestransportation issues that plague patients both socially andfinancially, immediate pick up and drop off increase compliance withpatient visits which would improve outcomes, wheelchair assessableautonomous vehicles will be available with assistance where neededSafety given extended hours of operation.

Within this electronic medical record will be the ability of eachindividual discipline or specialty to input appropriate quality targetindicators and have these measured for each individual most responsiblephysician or discipline involved in the care of patients to calculatequality of care indices to be tracked and used in a way to continuallyassess for quality improvement.

The design as shown herein improves patient flow to prevent the spreadof infectious disease. The parking garage, as illustrated in FIGS. 14and 15 , aligns with multiple flows housing multiple services to reducethe need of elevator use. Further, North and South elevator locationsallows designation of the south side for entrance for all floors abovethe first floor and the north side elevator to be used to exit to mainfloor avoiding waiting rooms with immediate east-west exit afterreaching first floor. Direct access to each floor from the parkinggarage allows isolation of vulnerable populations and staff to singlefloors.

Now referring to both FIGS. 52 and 53 , the present system solutioninitially includes a physical arrangement 2000 of the bloodlettingstations and sorting of specimens including a first level 2220 and asecond level 2222. This is on the first floor of the clinic immediatelybelow the larger full laboratory (level 2) where specimens areprocessed. On level 1 (2220), such as shown in FIG. 52 , eachphlebotomist has their own room 2110 for bloodletting and immediatetransfer of specimen to the sorting area. A plurality of washrooms 2104are used for urine collection specimens are immediately across from thebloodletting rooms 2110 used for that particular patient. Thephlebotomist on collecting the desired specimens transfers them to thesorting area directly without having to leave their room through thewindow 2111 identified in FIG. 52 . As further illustrated in FIG. 52 ,the layout includes a secondary receptionist 2102 to greets patients andto direct patients to the proper areas. The work space in the layout2000 further includes a workspace 2106 and at least one lift or otherelevators 2108 configured to move material to Level 2.

FIG. 53 illustrates a unidirectional flow 2202 (as evidenced by thearrow 2202) of the specimen from the time of bloodletting etc. tosorting to transfer up a lift system directly upwards to the fulllaboratory on the floor immediately above the specimen collection site.The specimen moves from Level 1 2220 from collection 2204, to sorting2206 up though the transfer 2208 as illustrated by the unidirectionalarrow 2202. The specimen then moves up to level 2 2222 up to processing2210. On level 2 2222 of the full laboratory, the specimen is processedwithin 10 minutes for patients who are attending clinic on the same dayso the results are immediately available for their assessments. Thereusable supplies are then transferred back down to level 1 2220 whereany reusable supplies 2212 are transferred back. The transfer occurs ona lift or other similar transportation system configured to transportthe physical specimens.

This physical set up and procedure for laboratory specimens collectionand processing has the potential to reduce emergency room utilization aswhen labs are done 1-2 weeks prior to the clinic visit, patients areoften directed to the emergency room to deal with issues on theirlaboratory investigations because clinical assessment is not immediateat the time of the testing. In this model, because the testing is thesame day as the clinic visit, patients will be assessed and issues dealtwith identified on their lab work on the same day.

This also enables clinicians to react to real-time immediate results intheir clinical assessments. It reduces the need for repeat lab work dueto data that is not most current. The present 2 level (or otherwisemulti-level) system is advantageous because if the lab was next to theclinic on the same floor, it would not be as efficient a process withcollection, processing and transfer back and forth of specimens andsupplies. The 2 level arrangement allows samples to be transferred up tomaximize floor space to mitigate the need of transfer carts, people . .. etc. to physically move the samples across a building. Movingspecimens vertically and mechanically is significantly more efficient.

It allows for increased utilization of more cost effective real-timeimmediate community-based clinical assessments and less reliance onemergency room departments and hospitals to be able to do real timeimmediate laboratory investigations and assessments.

The design of the present specification is configured to eliminate thefundamental problems, as previously described, with the currenthealthcare model. Patients will have access to their primary carephysician, a select group of vascular health specialists, includingcardiology, nephrology, endocrinology, neurology, and vascular surgery(available on-demand for ‘quick’ problem specific consultation), amedical laboratory, imaging, diagnostics, and pharmacy services, all atthe same location, and in the same visit.

By implementing the below described design and utilizing thecorresponding computer program and companion mobile device application(as described in the parent), healthcare providers will be able toincrease the efficiency and quality of healthcare delivery, facilitateand simplify coordination of care, enhance patient involvement inhealthcare decisions and measure and improve health outcomes in patientswith vascular disease through clinical evidence-based strategies. Byimplementing this complete design, a new gold standard of healthcarewill be achieved.

The present specification includes both an Electronic Operating System(EOS) for the clinic and autonomous vehicle management system and forthe Electric Autonomous Vehicle itself.

Electronic Operating System (EOS)—Clinic and Autonomous VehicleManagement System

The EOS as herein described is the operating system of the vehicle andthe entire clinic. Not only does the EOS allow navigation through theclinic etc. (such as previously described and herein incorporated byreference) but it is actually the vehicle operations system as wellwhich controls mechanical autonomous functions and mechanical remoteoperational technology and artificial intelligence systems.

The same automation occurs in exam rooms at the clinic so the staffnever has to go into the room. With the screens facing the patient thecamera system and the EOS program, the assessor doesn't even have tophysically be in the building or even in the city to assess the patient.

Further, the EOS provides for the ability to incorporate artificialintelligence in making diagnoses and suggesting treatments. For example,the ability to scan a skin rash and compare it to a database. Anadvantage is the ability to make a diagnosis and prescribe therapyimmediately.

Eventually, the physical building is a command center with rooms andworkspaces. Nurses and staff video will conference into the vehicle andasks the patient questions to prepare for a visit so in the transitionphase, your assessment starts the minute the patient leaves their homeand makes the entire visit more efficient. This can be done through acommand center that is exclusively focused on this, once the volume forthe service increases.

After transitioning to completely virtual assessments, physicalexamination, lab work and imaging internal assessments can be donethrough the electronic operating system using remotely controlledrobotic apparatus. This will combine x-ray technology, ultrasound,Imaging sensor technology and camera technology both attached toindividual equipment and in the outer and interior frame of the vehicle.The vehicle itself will have equipment within the frame of the vehicle,both on the outer and inner aspect that will facilitate autonomousoperation and clinical assessment.

If labs have already done by mobile lab draw, the clinic visit can beenperformed virtually from a patient's driveway with clinical assessmentand imaging data taken in the vehicle and video conference informationfrom the command center.

The same vehicles can transport people to and from the emergency room innon-life-threatening situations for assessment from the clinic and thento their homes also, with communication of their electronic medicalrecord and medical history with that emergency room department. Duringany assessment, continuous monitoring of vitals and parameters andparticularly on transport to the emergency room can allow therecognition of concerning heart rhythms and one of the devices thevehicle will be equipped with is an automated external defibrillatorthat will positioned and used if a shockable rhythm is detected.

In terms of the artificial intelligence used with the equipment,equipment can learn to recognize landmarks while scanning a patient'sbody to determine the direction of probes such as ultrasound probesrequired to complete a full examination. This is true for the placementof blood pressure cuffs sensors, EKG sensors, Carotid Doppler sensorsand any other imaging.

The cab component of the vehicle and functions can be duplicated for athome use once the technology costs decline over time. Using thetechnology remotely will be controlled by the natural movement of yourhands that is detected by the Artificial intelligence programming andvirtual space mapping.

In the interior compartment, a centrally positioned is present that canswivel and lock in place can initially be healthcare personnel andtransition to being used by a caregiver that assists patient from thesame household with virtual assistance.

The coordination and professionals doing the virtual care can be basedfrom the research facility—but doesn't have to be. This allows for thepatient to have care delivered by the physicians and allied healthcareprofessionals of their choice regardless of location. The coordinationcan occur through the Research facility in command Center at the mainbase. This is where the virtual technology specialists will be stationedthat can control the equipment with precision. They will be the ones whoare controlling the vehicle Equipment from the command center and havespecialized training in that particular technology.

The EOS will control the path and scheduling and destinations of thefleet of autonomous vehicles. EOS will be integrated with the hardwareand control the hardware within the autonomous vehicle. The EOS willalso be the portal through which control of the hardware within thevehicles is allowed through strict permissions. It will also serve asthe portal for controlling hardware devices remotely.

The EOS system coordinates activity in the fleet of vehicles as well asactivity in the physical plant structure.

The EOS coordinates the notifications to both practitioners and patientsand the distance to the next scheduled patient and the type of careneeded at what time—when the next car becomes available that is suitablefor that specific visit.

The EOS Keeps digital video records of physical examination forcomparison. No more writing down what you saw—now you can actually seedata and measure specifically things like Edema, rashes, jvp, recordheart sounds, assess appearance, lymph nodes, ascites, x-ray images,ultrasound findings within a single record and compare to previousimages etc.

Electric Autonomous Vehicle

The Vehicles of the present specification are electric autonomousvehicle capable of holding 2-3 passengers and is wheelchair accessible.The back windows are tinted dark for privacy. One body for all differenttypes of vehicles. The only difference is the technology placed in eachvehicle. The advantage to this as a vehicle made with minimaltechnology, for example the pharmacy car can be easily retrofitted to beany other type of car. In this configuration, the car is modular aswell. The back compartment is tall enough for a patient to stand, sitand completely recline. This large space will help in the ability due todiagnostics—such as x-ray and ultrasound imaging. However, the cab willbe still short enough to go through any overpass and even park in yourgarage. The doors open up and have no handles. The doors can be openedand closed through the command center only when the vehicle is in park.

The inside of the vehicle is adapted to include all necessary componentsfor patent evaluation and diagnosis. Every piece of equipment is builtinto the vehicle system and comes out of the vehicle itself. Forexample, blood pressure, EKG lead and other diagnostic equipment arisefrom the interior side walls, floor or roof of the vehicle and throughcamera systems at the exact spots needed.

In some examples, the mobile lab draw with lab tech in front, plexiglassscreen separating lab tech from patient with place just put an arm andcan go around to do lab draws if needed to avoid clinic visits in apandemic. The lab draws will transition to ultrasound guided veinmapping remote phlebotomy using robotics to exactly insert the needleinto veins with direct ultrasound visualization which will minimizetrauma to the patient.

Evolution to robotics where everything is touchless is incorporated intothe present autonomous vehicle. The entire exam is done by controllingthe apparatus and equipment either through a manipulation of the controlsystem or eventually by hand motion and can be done remotely fromcommand center. Procedures such as examining a patient's throat or earsor nasal cavity, or performing a full ultrasound of the abdomen and or achest x-ray are examples of how remote robotics and technology will beused in the system to facilitate clinical assessments. By way of anotherexample, of the robotic control of a stethoscope with audio recordingand transmission to the control center can allow a clinician to remotelylisten to a patient's heart and lungs. As another example, the use ofthe robotic arm with a simulated hand attached can allow the clinicianto examine the patient as if being present in the vehicle.

Viewer and screen for family or caregivers who are given appropriatepermissions to join in on the visit and can do so from any location.This allows family members and caregivers to be present without undueinconvenience.

As a transitional phase from in person to completely remote clinicalassessments, a divider can be placed such as plexiglass between theposterior and anterior components with appropriate carrots to allow safeassessment a patient brought to the physical plant in assessment baysthat are open air as in the physical plant design.

Both the anterior and posterior compartment of the vehicle will haveindependent negative pressure ventilation systems built-in to minimizethe risk of infectious transmission.

Both the anterior and posterior compartments will have self-disinfectingsystems. Touch sensors and scanners and cameras will provide anautomated identification of priority areas for disinfection and therewill be a generalized aerosol disinfecting system built into theinterior of the vehicle. The system detects everything that eachoccupant touches to focus areas of disinfection and disinfectantevaporates within minutes. Disinfection occurs in transport betweenlocations and there is generalized aerosolized disinfection of thecompartment as well for droplets.

The patient seat is electronically controlled for positioning byassessor.

Further, different models of the vehicle can be produced and even easilyretrofitted to transition from one model to another if needed. By way ofexample, different Models includes:

-   -   Model A—examination and questionnaire    -   Model B—lab draw    -   Model C—imaging    -   Model D—pharmacy pick up and drop off with counseling    -   Model E—combine all

The panels of the vehicle contains strategically placed instruments thatcan robotically be extended to the desired site use and positionedappropriately. Cameras and sensors allow appropriate visualization andclinical data collection. Robotic arms are strategically placedthroughout the posterior compartment and will have access tostrategically placed supplies all of which can be controlled from withinthe anterior compartment or remotely.

In some embodiment, the scheduling system allows for scheduling multiplespecialists and allied healthcare professionals to assess the patient atthe same visit. The scheduling process not only sends out the autonomousvehicle for pick up but also is able to generate preassessmentquestionnaires for each health care. A specialist seeing the patientthat day. These can be displayed in the vehicle on the drive to theclinic and the questions can be asked of the patient by automated voiceover and using voice recognition they can submit their answers whilethey're being driven over.

The virtual healthcare provider can review the answers given by thepatient and can then talk to the patient to clarify any of theiranswers.

It is noted that the terms “substantially” and “about” may be utilizedherein to represent the inherent degree of uncertainty that may beattributed to any quantitative comparison, value, measurement, or otherrepresentation.

These terms are also utilized herein to represent the degree by which aquantitative representation may vary from a stated reference withoutresulting in a change in the basic function of the subject matter atissue.

While particular embodiments have been illustrated and described herein,it should be understood that various other changes and modifications maybe made without departing from the spirit and scope of the claimedsubject matter.

Moreover, although various aspects of the claimed subject matter havebeen described herein, such aspects need not be utilized in combination.

It is therefore intended that the appended claims cover all such changesand modifications that are within the scope of the claimed subjectmatter.

We claim:
 1. A method of automated medical scheduling comprising:receiving user specified data on a processor via a checklist, said databeing a plurality of predetermined physical conditions of a patient,each of the plurality of predetermined physical conditions having apredetermined assigned weight based on level of severity; generating asummation of the total weight for each predetermined physical condition;generating a predetermined specialty acuity (“SPA”) score by comparingthe corresponding range of the total weight; and using the SPA scoreused to schedule appointments for patients in a system schedule and toschedule sending of an autonomous vehicle sent to the patient forpickup.
 2. The method of automated medical scheduling of claim 1 whereina SPA score is generated for each system affected, the systems includingCardiac, Renal, Neurological, Vascular, Medical/Metabolic and Pulmonary,each assigned a value of
 1. 3. The method of automated medicalscheduling of claim 2 wherein a comorbidity score is generated by thesummation of each system.
 4. The method of automated medical schedulingof claim 3 wherein a Total Overall Risk (“TOR”) score is generated bymultiplying the summation of each system by the total SPA scores,generating a report of the TOR score.
 5. The method of automated medicalscheduling of claim 4 to determine frequency of appointment scheduling,comparing the TOR score to a set of predetermined ranges, assigning anappointment interval corresponding with the TOR score value.
 6. Themethod of automated scheduling of claim 5 wherein an appointmentinterval is assigned for ancillary care assessments corresponding to theTOR score value.
 7. The method of automated scheduling of claim 4wherein the TOR score is used to determine visit frequency as anamplifier for SPA score passed on physician visits.
 8. An autonomousvehicle for transporting a patient to at least one medical appointment,the autonomous vehicle comprising: a plurality of sensors, the pluralityof sensors selected from a group of: cameras, blood pressure sensor,ultrasound, x-ray, EKG sensor, heart sensor, blood sugar sensor, and/orperspiration sensor; and a display within the vehicle, the displayproviding for virtual communication with a remotely located health careprofessional.
 9. The autonomous vehicle of claim 8 wherein a robotic armis positioned within the vehicle, the robotic arm configured assist intesting the patient.
 10. The autonomous vehicle of claim 8 wherein thedisplay is voice activated.
 11. The autonomous vehicle of claim 8wherein the display is configured to accept voice recognition.